Inspection on 09/11/06 for Parkwood Lodge

This inspection was carried out on 9th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Parkwood Lodge 04/01/06

Parkwood Lodge 04/07/05

Parkwood Lodge 26/11/04

Parkwood Lodge 04/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Parkwood Lodge 181 London Road Waterlooville Hampshire PO7 7RL Lead Inspector Val Sevier Unannounced Inspection 9th November 2006 09:30 Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Parkwood Lodge Address 181 London Road Waterlooville Hampshire PO7 7RL 023 9226 8073 023 9226 8073 parkwood@truecare.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Truecare Group Limited Mrs Tracy Ann Clare Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 named person may be accommodated in the MD (E) category. Date of last inspection Brief Description of the Service: The home supports up to seven service users who have mental health disorders and/or learning disabilities, including people with disabilities within an autism spectrum. This support comprises assisting them to live comfortably within the community and to find ways of recognising and coping with their disabilities and challenges. The premises are a detached property with parking at the front and enclosed garden at the rear. There is a lounge, conservatory and kitchen/dining area. Each service user has a single bedroom with full en-suite facilities. Three of the bedrooms are on the ground floor and seven are on the first floor. A passenger lift connects the 2 floors. Twenty-four hour care is provided with two members of staff on duty at night. The home is owned by an organisation that has a number of other similar residential homes in the county. The manager therefore has the support of additional professional services e.g. an operations manager, a clinical services manager and human resource services. The fees for the service are based on individually assessed needs and range from £1900 - £2500. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included: an unannounced visit to the home, which was carried out on the 9th November 2006, during which the inspector was able to have discussions with staff and residents at the home. In addition 6 relatives and 6 of the 7 residents had completed questionnaires prior to the visit. During the visit to the home a tour of the premises was carried out with permission of the residents at the home, this also included their rooms. Staff and care records were sampled and in addition to speaking with staff and residents, their day-to-day interaction was observed. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. During the conversations with the residents they shared their experiences of living in the home, some have been living at the home since it opened three years ago, and have had some say in what happens there. What the service does well: Residents receive good support for a wide range of needs, which can be challenging both to them as individuals and to the staff. The staff are able to provide a good service because it is based on their knowledge, experience and training. This is supported by the care plans and other written documentation, which have been agreed by the residents. The home is ‘homely’, with bedrooms personalised and communal areas comfortable. The residents are encouraged to comment freely about how they feel the home is run, which is useful as part of the encouragement of individuals having choice and their views known. Staff were seen to treat residents with respect and dignity and encourage risk taking as part of daily life activities. Residents and relatives both verbally and in comment cards were in agreement that the attitude and level of care was very good. One relative commented, “the staff always listen to my relative and to any concerns that I have…they always let me know if there are any concerns”. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a very good understanding of residents needs using the assessment process. The admissions process is very good, providing prospective residents and their families with details and opportunities to enable them to make an informed decision about admission to the home. EVIDENCE: The manager has reviewed the home’s service user’s guide. It incorporates a statement of purpose that is specific to the home and meets current regulations. All care is taken in assessing prospective residents to fill any vacancies at the home as this ensures a well-balanced community. The staff are aware of the needs of service users and of how their needs and aspirations can best be met. An information pack is given to individuals where an interest in the service has been perceived. It contains all the information necessary for someone to make informed decisions as to whether the care offered at the service is for him or her. The inspector sampled three files and they all contained pre admission assessments. Information was also available from social services and health professionals as appropriate. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 9 Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 6, 7, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff have an excellent understanding of the residents support needs. Residents receive the level of support and guidance they need in order to meet their specific requirements. The communication and understanding between residents and staff is excellent. Residents are supported to take risks in their daily lives. Information concerning residents is handled appropriately and with confidentiality. EVIDENCE: The inspector sampled three care plans on this occasion and was able to speak with several residents about their care programme. The care plans that have been developed for the residents were seen to be a working tool, with records of daily life monthly evaluations by the key worker. There was a lot of evidence that there is participation by the residents in forming their care plan, it is referred to daily with a record of activities that the individuals carry out as part Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 11 of their plan. This file contains the views of the individual their life story, what they hope to achieve, goals and ambitions and the assessment of their key worker. It also contains their progress. The residents are closely involved in all aspects of life at the home, where more rigid frameworks are required for the well-being or safety of a resident, for example these instances are identified, recorded, agreed and reviewed. The residents spoken with said that although they were living in a care home, they had a say in what happened both as a group and as an individual. They were happy that staff on occasion had to make a decision and when this happened, an explanation was given as to the decision. So although they may not have liked the decisions, they are least given an opportunity to understand why it had been made. Care plans and information regarding residents was seen to be kept in locked cupboards and the room was locked when staff were absent. Residents spoken with felt that their confidentiality was kept both in writing and verbally. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16, 17. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The residents receive excellent support, to fulfil their personal development and leisure activities, which are based on their individual abilities and aspirations. The residents are supported in the preparation and choice of their meals, with specific dietary needs also being addressed with encouragement to carry out these tasks on their own. This is highly commended. . EVIDENCE: The residents have a wide range of mental health issues which need constant support from staff, to prevent or minimise what would be regarded as “challenging” behaviours elsewhere, to do this staff need up-to-date knowledge of each resident. Individual activities and interests are agreed and are met by the local community, with no resident being dependent on attendance at local authority or private day centres. On the day of the visit, one resident was on ‘home leave’ with their parents, some residents were at home, being supported Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 13 by staff in to carry out household activities such as food preparation, laundry and cleaning/tidying; whilst others had gone out either with support from staff or independently. All bedrooms are decorated and furnished to individual tastes and requirements, and reflecting the individuals specific and general interests. Routine activities that have been agreed with residents take place and are amended from time to time or at short notice depending on the disposition, health and continuing abilities/aspirations of the individual. Residents explained that they could go where they like either with support or on their own, if able. There was evidence that one resident who likes horse riding had become frustrated as they wished to be more involved in the management of the stable in addition to riding. The situation was reviewed and following discussion with the stable this has been arranged. The rapport and communication between the staff and residents was evident through observation, and confirmed by the residents. Mealtimes are variable depending on the individual daily activities of the residents. Residents are able to have their meals or snacks where they wish. Staff join the residents for meals and the group tries to meet up once a day to ‘catch up’ on what has been happening. Residents are supported to cook/prepare their own lunches with the tea time meal being more communal, although individual choice was evident with alternatives being prepared. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and emotional needs of residents are known, well met and reviewed with evidence of good multidisciplinary working taking place on a regular basis. EVIDENCE: The inspector was able to see from care pans and from discussion with both staff and residents that needs are being. The residents have a wide range of needs, including mental health difficulties and/or learning disabilities including Asperger’s syndrome, severe depression that for some has lead to other behaviours for example self-harm and obsessive-compulsive behaviour. The residents have access to GP’s, community psychiatric nurses and other healthcare services. Care plans seen at the visit have detail on how mental and physical healthcare needs are identified and met. The manager outlined how personal development support and training for staff enables them to continue to monitor complex conditions and to obtain healthcare support to complement their support and guidance. The medication records and storage were seen and were appropriate to the needs of the residents and in line with the homes policy. Weekly checks of Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 15 stock are undertaken by staff to ensure that her there is no over ordering and that medication remains in date. Two residents currently self medicate one with all medication another with insulin. They have safe and locked storage for these medicines. There was evidence from talking to both residents and staff that individual health care needs are addressed. With an incident recently that meant the home needed support from external health care. The needs of the individual were planned for which included involving the community in the form of the local church where the resident attended. The home is a ‘home for life’ provided that there is support from the local community and health care. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their views are known to staff and are fully taken into account. The manager has established a sense of openness at the home so that relatives and residents can voice their concerns. Staff also feel that they can voice concerns especially regarding the care of the residents. EVIDENCE: The home’s complaint’s book was seen. The manager explained that in order to further protect residents and others information the complaints book is now numbered and the pages are filed away when actioned and completed. There have been no complaints made to CSCI and any complaints made by residents have been actioned and managed. Residents spoken with said that they had had their complaints answered and explained. The examples of complaints seen, evidenced that residents complaints are seen also as therapeutic activity for the individuals and the outcomes contribute to quality assurance measures of the service. Any concerns have been recorded with action taken, staff are aware of the adult protection pricy and whistle blowing Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are suitable for the care of residents with the appearance of the home creating a comfortable and safe environment for those living there. EVIDENCE: Refurbishment discussed and recommended from the previous inspection has been carried out. The premises are well maintained, clean and tidy. All residents have single bedrooms with en-suite facilities, 3 bedrooms are on the ground floor, four are on the 1st floor and there is a passenger lift. There are good internal and external facilities. Communal areas enable service users and staff to have space, comfort and privacy. All residents have access and use of the kitchen and laundry and they are supported to be as independent as they can in their own care and daily household activities. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 18 Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well looked after by an effective staff group. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to maintain and improve their quality of life. EVIDENCE: The staffing structure provides a broad spread of experience and professionalism: manager, assistant manager, two team leaders, and senior support workers. The organisation and other health care professionals support the team eternally. The duty rota showed how staff are deployed at the home and accompany residents in the community, there are 4/5 members of staff on duty between 8:00 am – 8:00 pm). The staff told the inspector that they receive regular supervision and yearly appraisals from the manager; the tracker the manager uses supported this. The manager told the inspector that appraisals are carried out in November for all staff and this helps her plan the training and development for the home for the coming year. The manager continues to ensure that staff are trained in NVQ with three staff currently attending a local college. There are 10 members of staff who have Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 20 achieved NVQ Level 2 in Care and 3 have achieved the Certificate in Community Mental Health. The manager is committed to securing specialist mental health training for all members of staff. The training matrix that is maintained indicated that all members of staff are encouraged to achieve training in topics relevant to residential care e.g. safe moving/handling, understanding reasons why people become agitated or upset, food hygiene and first aid. The inspector was able to sample the recruitment process with the home keeping basic information and confirmation that the recruitment process has been followed. The organisation now keeps the original documents for recruitment at the head office. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 37, 39 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed with residents placed at the centre of a service delivery that in areas exceeds the standards. The manager has a clear vision for the home, which she has effectively communicated with staff. There is clear leadership and staff support and training so that the needs of residents can be met. There was evidence that health and safety is attended to protecting the well being of all at the home. EVIDENCE: The manager has achieved NVQ Level 4 in Care, the Registered Manager’s Award, Certificate in Community Mental Health and HND/BTEC Managing Health and Care. Her experience from years in this field of work were evidenced by the observed interaction between the staff and residents, the record keeping sampled and the comments from residents and staff as to her Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 22 qualities of leadership and management. The manager was able to evidence that the recommendation from the last visit for an increase in her management hours by the company had been agreed. Although she does work on occasion on the ‘floor’ when the need arises, this is not now an expectation. During the inspection visit, it was clear from observation and sampling records such as care plans, that residents needs were identified and individual programmes of care were agreed and in place, with their needs and aspirations being an important part of their personal development. The staff when spoken with, had clear information on how to meet individuals needs, they said that they felt supported even if things did not always go to plan and teaching by the manager using her experience was as needed, in addition to the formal training that the manager carried out. Staff said that they felt that their development needs were met and that they had regular supervisions as well as yearly appraisals. The manager had completed a pre inspection questionnaire for the home for this inspection year, which detailed that all necessary safety checks and associated certificates were in place. This information was sampled and it was found that a file is maintained in which such safety certificates/information are kept. The manager was confident that all safety checks have been carried out. There was evidence of risk assessment procedures being in place and training standards are such that the vulnerabilities of residents are known and addressed in operational activities. The service carries out a quality survey using questionnaires the results of which were made available to the inspector at the visit. The questionnaires are sent to residents, staff and relatives, comments where discussed with the manager and she was able to show any action that had taken pace as a result of the comments. Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 3 X Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Parkwood Lodge DS0000055449.V318914.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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